ZEST insights

Happy New Year and welcome to our first blog for 2009!  January is always a busy time for us here at ZEST, as we prepare materials for our clients’ cycle meetings and complete the finishing touches to new programs and educational activities that will be rolled out when the reps get back on the road. We’ve also been working on a number of ZEST initiatives that we’re very excited about. We understand that it’s important for you to measure performance and ROI on the projects, so we’ve given a lot of thought to how we can capture this information in a systematic and meaningful way. I won’t say anything more for now, but look out for our ZEST Performer initiative, launching next month. 

Also coming soon is our new look website, which will feature improved navigation, updated information and some rather spiffy photos of the ZESTers!

Like everyone else, we’re not immune to New Year’s resolutions and the ZEST Wellbeing program for our team has kicked off with vigour (think healthy eating, massage, yoga…). And we’re proud to have entered out first team in this year’s Corporate Triathlon. We also promise to blog a little more frequently, sharing insight and ponderings from the world of healthcare and medical education. It promises to be an interesting year as the globe moves into uncharted territory in the financial sector and we wait to see what impact the far reaching consequences seen in the Northern hemisphere will have on us here in Australia. We encourage you to join in the discussion and comment, query and challenge the blogs we post – we love a lively debate! We wish you a happy and successful year and look forward to working with you in the coming months

ZEST Healthcare Communications specialises in the creation of medical education programs and materials designed to inform and educate healthcare professionals and consumers. Our materials run across all media, including the latest in online technologies. The strategic intent of these programs and materials is to positively transform the way people think about a disease area or brand.

When we talk about ‘next-generation’ medicine, we tend to think about advances in treatments, diagnostic tools or preventative approaches such as vaccines. But what about ‘next-generation’ healthcare providers?

Currently in Australia, over 60% of GPs belong to the ‘Baby Boomer’ generation - defined as those born between 1946 and 1964. And just over 14% of our GPs are ‘Builders’ – born between 1925 and 1945. But over the next few years, as the Builders and older Boomers move into retirement, our GPs will become predominantly Generation X. 

So what does this mean; what’s going to change? 

Traditionally, a generation was defined as the average time between the birth of parents and offspring – roughly around 30 years. However, with the arrival of the Baby Boomers, generations have instead become defined by societal values, the emergence of new technologies and the influence of world events. As a result, Baby Boomers and Generation X have very different values, approaches to technology and, as a result, different communication styles. 

Generation X was born into the technology boom. This means that they readily embrace new technologies and have adapted their communication style to take advantage of them. Gen X are highly computer- and internet-literate, regularly use mobile technology and have an expectation for instant digital communication. Contrastingly, the Boomers can be very wary of the internet and mistrust the security of digital channels. 

As our predominant GP population shifts from Boomer to Gen X, and the even more technology-dependent Gen Ys start graduating from medical school, the way we interact with our GPs will therefore change. There’s already been a shift towards digital patient records, electronic appointment systems, and electronic prescribing software, but Gen X doctors will lead the drive to take digital healthcare to the next level. Personal health records stored on smart-cards? Test results over email? Instant online chat with your GP? Skype consultations? Next generation medicine really could revolutionise our healthcare.  

This is great news for pharma marketing, as new opportunities arise to communicate with both doctors and patients and to provide value-added support to help Gen X doctors bring their practices up to date. Here at ZEST we’re keeping a close eye on developments in this area and our digital team is already creating novel communications systems that put our clients at the forefront of next-generation medicine.   

At ZEST we love a revolution. Call us on 02 9409 7600 to find out how you can be part of this one.

The arrival of the iPhone and other smart phones has quickly changed the way we use the internet.  Email and SMS technology has been available for many years via your mobile but the ability to easily access You Tube, Google maps, Safari and a host of other content through an iPhone is revolutionary.   

The day iPhone arrived in Australia, ANZ launched a specific Mobile Web site with Qantas quickly following suit. The proliferation of hand held devices has forced these companies to think about a wider customer group and develop specific Mobile Web content. 

Small screen size and other limitations such as poor download speed means the functionality of Mobile Web – for the time being – is limited and usually focused on the most commonly accessed services on the main website. Currently, images and words need to be pared down to allow the user to move quickly through the site.

In an attempt to improve the Mobile Web user-experience, standards are being developed. Wikipedia has further information about this, including the W3C Mobile Web Initiative, which aims to develop best practices and technologies relevant to Mobile Web. The hope is that this will make browsing the Web from mobile devices more reliable and accessible.  

Despite the need for improvements, mass consumer uptake of the iPhone and its relatively user-friendly browsing experience means we need to get serious about providing tailored websites for hand held devices. The potential benefits for patient support and healthcare professional engagement are significant.   

At ZEST we believe that as we progress through 2009 we will routinely be asked to create Mobile Web content as part of the development of all websites. It’s something we’re excited about and look forward to providing an innovative way to interact with patients and doctors. Stay tuned to the ZEST blog for further updates about how Mobile Web can work for you! 

When you hear the term ‘key opinion leader’, who immediately springs to mind? A specialist or GP who commonly takes the lead in a therapy area, or maybe a leading academic in a particular field of research? But do your thoughts extend to members of other healthcare professions – say nurses, pharmacists, or physiotherapists? 

Allied healthcare professionals are likely to become more influential in patient management, with the Australian government taking active steps towards expanding their clinical roles to address the shortage of primary healthcare providers in this country. So it’s timely to begin challenging traditional concepts of a KOL and, by extension, your target audience.  

One key group to consider is nurse practitioners. These are nurses with the training and authority to manage patients, refer them to other healthcare professionals, and prescribe some medications. There are currently 300 nurse practitioners in Australia but Federal Health Minister Nicola Roxon has suggested that this number be expanded to address the current workforce shortage in primary care. 

Do you have a program for nurturing leading nurse practitioners to ensure they remain in touch with your latest developments? Or is there another group of professionals – perhaps pharmacists - you want to engage? 

At ZEST, we can help you identify and nurture KOLs from a range of healthcare professions to help you gain the most from their expertise and provide opportunities for them to develop as advocates. Call us to discuss our KOL Care Continuum programs and we’ll help you stay ahead of the changing healthcare landscape in Australia.  

As budgets get smaller and pharmaceutical companies get more competitive, we are constantly striving to find different ways to market new therapies. Some companies are attempting to secure doctor and patient groups even before their therapy has received approval. 

The latest company to do this is GlaxoSmithKline. Recently recruiting via the radio for a clinical trial, they required patients with severe rheumatoid arthritis who had not previously taken biologicals. And in doing so, taking potential patients away from approved drugs on the market such as MabThera RA, Humira and Enbrel.  

Pre-marketing activities such as early access, product familiarization and compassionate access programs are becoming more and more important when planning for a new product launch. These are an effective way for doctors to start gaining experience with the drug as well as capturing patients, who will usually stay on the therapy once PBS approval has been given. 

Although this has been going on in clinical trials with terminal patients (eg cancer patients), will we start seeing more of this in chronic conditions, such as rheumatoid arthritis?

express /əkˈsprεs/

1. To put thought into words: to express an idea clearly

2. To show, manifest, or reveal: to express one’s feelings

3. To make known feelings or opinions

4. To send by special messenger or rapid transport

5. Sent out with or moving at high speed

6. Direct, rapid, and usually nonstop

You know when you’re just bursting to tell everyone your exciting news? Your daughter just took her first steps; you’ve got a new tattoo; the Swannies thrashed Collingwood – that sort of thing? So you make a few calls, send some emails or texts, update your blog. If you’re feeling very retro you might even handwrite a letter, depending on what works best for your nearest and dearest. 

But what if your news is just as important but not quite as personal? Perhaps your product finally got PBS listing; there’s a supportive paper in The Lancet; you’ve confirmed a fantastic global speaker for your conference; or you can prove that scathing article in the tabloid press is a load of unfounded rubbish? Don’t you wish there was an easy way to get your message to your key customers in a way that will engage them NOW?   

Well, with ZEST Express – our exciting new service – you CAN reach everyone. Fast! 

The idea behind ZEST Express is simple but effective: we maximise uptake of your message by combining several different media. So no matter how someone likes to get their information, we’ve got it covered! Plus receiving the same information in several different formats reinforces your message.  And because we can usually get the first wave of communication out in a matter of days, it’s certainly fast. 

So if you’ve got news you’re bursting to share, email us today at info@zesthealthcare.com.au or call us on 02 9409 7600. See how ZEST Express can take your message further!  PS You can also find more information about ZEST Express on our website.

The AMA has warned that the new WorkChoices legislation allowing any registered health practitioner - including pharmacists, naturopaths and iridologists - to issue sick leave certificates could put lives at risk. “I might present to the pharmacist having needed to take the day off work because I have headache … I might get my certificate for two days but in fact I’ve got meningococcus and I am dead within that 48-hour period because I haven’t seen a doctor,” suggests AMA president Dr Rosanna Capolingua.

Well, that may be true. But it’s fair to say that there are enough reports of GPs (and doctors working in Emergency Departments, for that matter) having not picked up meningococcus in patients with headache that it’s probably not the best example to use to fight this issue. GPs may have genuine concerns about the consequences of pharmacist-issued medical certificates, but it also seems as though a bit of a turf war is going on. It’s not difficult to understand GPs feeling threatened that their role is being usurped with changes like this and that their skills are being undervalued by society. But pharmacists can be GPs’ most valuable allies if they work in partnership rather than in competition – each day, pharmacists refer patients to their GP if there’s anything that indicates the need for further medical attention. This isn’t likely to change with this new legislation.  

The Pharmaceutical Society of Australia and Pharmacy Guild have produced joint guidelines on how to issue medical certificates. According to these, pharmacists should not issue certificates for a period of more than two days and can only issue certificates within the scope of their professional expertise. As Pharmacy Guild president Kos Sclavos explained, most certificates would likely relate to cold and flu. Other conditions could include psoriasis or head lice.

The Christmas lights are up and the 2007 business year is hurtling to an end. This will be our last post for this year and it’s a good opportunity to stop and reflect on the past year and to look ahead at the emerging trends for 2008.

The most recent event and possibility the most significant for our industry is the change of government with Kevin 07’s team romping into power. What we do know is Labor’s health platform included review of the chronically under-funded hospital system, development of GP super-clinics to reduce the pressure on hospitals and a focus on aboriginal health. The newly-appointed minister for health and ageing, Nicola Roxon, is an unknown figure to most of us and we will have to wait and see what the policy direction she takes regarding PBS funding, MBS item numbers, nurse practitioners, chronic disease initiatives and the ubiquitous GP workforce shortages – all things that have the potential to impact on our business.

After nearly a year of argy bargy with the ACCC, the 15th edition of the code of conduct by Medicines Australia was finalised in August 2007. The stoush was over the new requirements for pharmaceutical companies to publicly disclose the level of hospitality and cost of all educational meetings and symposia. The reporting requirements are stringent and there is concern that doctors may be put off from attending these educational events. Again we will need to wait and see how this plays out next year.

On a more positive note, the RACGP changes for the new triennium have created opportunities for healthcare companies to provide valuable education via a number of channels. The revamped framework has left many of the old favourites like evening meetings, clinical audits, and active learning modules. But now there are some great additional ways to support high-quality education for GPs. In a nutshell they are: Evidence based journal clubs, Rapid PDSA cycles and mandatory CPR course.

This year e-marketing and social media (web 2.0) have started to impact healthcare marketers and the way they think about interacting with their customers. We are generally a conservative industry so it’s been exciting to watch the early adopters embrace social media tools such as podcasting and blogging. Our sister company, ZEST Digital, specialises in social media and on-line marketing, they have seen a significant increase in interest from pharmaceutical and healthcare companies; and currently have some innovative campaigns in development for disease awareness and product-specific programs.

Happy Christmas and a ZESTIVE New Year from the ZEST team.

The introduction of evidence-based medicine (EBM) journal clubs into the RACGP continuing professional development program represents a new opportunity for relationship-building with GPs. By providing support for these journal clubs, pharmaceutical representatives can reinforce relationships with their key doctors.

A workshop at the recent RACGP conference provided tips for establishing a successful journal club and overcoming potential barriers. For me, the workshop helped highlight the areas where sponsorship and support can be most valuable. It was run by a couple of GPs who have been involved in journal clubs in rural settings. They provided practical advice on the aspects that make a difference between success and failure. Read the rest of this entry »

In an earlier post I considered the likelihood that every doctor’s patients were compliant to their treatment regimens (not very) and why the hierarchical connotation of the word “compliant” itself might be stopping patients achieving their best possible health outcomes. (And thwarting the best efforts of the pharmaceutical industry’s marketing departments.)

I ended the post by suggesting that the “concordant” model for healthcare provider-patient relationships could be a thing of the future.

Concordance means “harmony” or “agreement”. So the concordant model is one of shared understanding.1,2 A genuine two-way dialogue between doctor and patient, where the patient’s beliefs and desired outcome are factored into the treatment plan - no matter how at odds they may be from the doctor’s own views.

As the BMJ put it: “Patients have their own beliefs about their medicine and medicines in general. They have their own priorities and their own rational discourse in relation to health and care, risk and benefit. These may differ from and sometimes contradict those of the doctors. They are, however, no less cogent, coherent, or important.”3

This is a tough call for doctors who are informed about what a treatment outcome should be from clinical trials and are trained to try and achieve that (the theoretical best) for their patients. To truly aim for concordance the doctor must accept that a different goal might be set for the person sitting in front of them if that person doesn’t share the same aspirations for treatment.

But this isn’t settling for second best. If the treatment approach embraces the patient’s beliefs and wishes the chances that he or she will actually stick to it are greatly increased. To use a dirty word, they are much more likely to be compliant.

Interesting as all this is, what relevance does it have to medical education and brand managers? Well, research may have focused on the doctor-patient relationship, but surely it equally applies to the interactions between patients on patient compliance programs - expensively provided by the pharmaceutical industry to offer patients taking their products a little extra help?

At ZEST we are moving away from creating rigid patient support/compliance programs with timeline-defined “touch” points pulsing out the same information to all participants, and embracing the principles of concordance. We recognise that people are different and need different support and they like it delivered in different ways. And while the brand managers among you might see dollar signs flashing before your eyes, a concordant patient support program need not cost the earth now that social media technologies are being so widely adopted.

1. Laurent C. Take one at bedtime and you’ll soon feel worse. Cancer World 2006; September-October.

2. Jones G. Prescribing and taking medicines. BMJ 2003; 327:819.

3. Marinker M., Shaw J. Not to be taken as directed. BMJ 2003; 326: 348-9.